Abstract
The purpose of this study was to investigate whether the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) can be used as supplementary tools to differentiate between benign, borderline, and malignant ovarian tumors. The ratio of patients with benign to borderline to malignant tumors was planned as 3:1:2 considering the incidence of each disease. Consecutive patients were enrolled retrospectively. Preoperative complete blood counts with differentials were investigated, and calculated NLRs and PLRs were analyzed. A total of 630 patients with ovarian tumors were enrolled in this study. The final histopathological results revealed that 318 patients had benign, 108 patients had epithelial borderline, and 204 patients had epithelial malignant ovarian tumors. The NLR and PLR were significantly higher in malignant than in benign or borderline ovarian tumors, and they did not differ significantly between benign and borderline ovarian tumors. The diagnostic cut-off value of NLR for differentiating between benign or borderline and malignant tumors was 2.36, whereas that of PLR for differentiating between benign/borderline and malignancy was 150.02. High preoperative NLR and PLR indicate that the likelihood of epithelial ovarian cancer is higher than that of benign or borderline tumors.
Highlights
Most cases of epithelial ovarian cancer are asymptomatic in the early stages, and there is currently no adequate screening test for early diagnosis, so they are often detected at an advanced stage and have a poor prognosis [1]
The purpose of this study was to investigate the differences in neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) levels in patients with borderline ovarian tumor compared to patients with benign and malignant ovarian tumors, and to determine whether they can be used for preoperative differential diagnosis
Tumor markers such as the CA125 and CA19-9 may be elevated in other benign diseases other than cancer; there are cases of ovarian cancer in which neither CA125 nor CA19-9 is elevated, which limits their roles in preoperative diagnosis
Summary
Most cases of epithelial ovarian cancer are asymptomatic in the early stages, and there is currently no adequate screening test for early diagnosis, so they are often detected at an advanced stage and have a poor prognosis [1]. Borderline ovarian tumors show excellent prognosis because the rates of metastasis and recurrence are low, and most patients are detected at an early stage and can be cured by surgical treatment. Preoperative diagnosis of ovarian tumors mainly depends on imaging studies including ultrasound and CT [2,3]. It is not always easy to differentially diagnose benign, borderline, and malignant ovarian tumors only by imaging findings. Tumor markers such as CA125 and CA19-9 play an adjunctive role in diagnosing of ovarian tumors, but are not diagnostic because of their low specificity [4]
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